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Individual
MRS. PRARTHANA NAREN MYSORE
Active
Individual
MRS. PRARTHANA NAREN MYSORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3663
AZ
363A00000X
Physician Assistant
Primary
52524
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3663
ARIZONA STATE LICENSE
AZ
01
—
52524
PA BOARD OF CALIFORNIA
CA
Enumeration date
08/09/2007
Last updated
09/04/2019
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